Breast Imaging and Radiation Oncology

Breast Abscesses: Evidence-based Algorithms for Diagnosis, Management, and Follow-up

Published Online:https://doi.org/10.1148/rg.316115521

The classification and pathophysiology of breast abscesses are reviewed, radiologic evaluation of breast abscesses is discussed, and different treatment alternatives are compared, with emphasis on a proposed treatment algorithm that has been validated by a multidisciplinary team.

Radiologists who regularly perform breast ultrasonography will likely encounter patients with breast abscesses. Although the traditional approach of surgical incision and drainage is no longer the recommended treatment, there are no clear guidelines for management of this clinical condition. Breast abscesses that develop in the puerperal period generally have a better course than nonpuerperal abscesses, which tend to be associated with longer treatment times and a higher rate of recurrence. The available literature on treatment of breast abscesses is imperfect, with no clear consensus on drainage, antibiotic therapy, and follow-up. By synthesizing the data available from studies published in the past 20 years, an evidence-based algorithm for management of breast abscesses has been developed. The proposed algorithm is easy to follow and has been validated by a multidisciplinary team approach and applied successfully during the past 2 years. Breast abscesses are a challenging clinical condition, and radiologists have a pivotal role in evaluation and follow-up of these lesions.

©RSNA, 2011

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Article History

Received: Feb 14 2010
Revision requested: Mar 31 2011
Revision received: May 24 2011
Accepted: May 24 2011
Published online: Oct 4 2011
Published in print: Oct 2011